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CPR (cardiopulmonary resuscitation), or mouth-to-mouth resuscitation, is a type of artificial respiration that you induce by exhaling your breath into the victim's lungs. There are three distinct methods depending on whether you're performing it on an infant, a child, or an adult. Here we'll discuss only child CPR, which is used on children from age one to eight. To learn about infant CPR, click here .

The techniques used to resuscitate adults, infants, and children are similar; one small difference is that it's generally easier to seal your mouth over both the nose and the mouth of an infant. You'll have to be a bit more careful with a child than you would with an adult. Don't tip a child's head back too far, for example, because a youngster's airway and neck are more fragile than an adult's.

Reading about CPR can't teach you to perform it well. The following child CPR checklist is meant only as a guide. For safety's sake, you should take an infant/child CPR course, which you can usually complete in a daylong session at a local YMCA, hospital, health club, community center, or chapter of the American Red Cross. For more information on classes, call the American Red Cross; look under American Red Cross in the white pages of your phone book.

Also, keep in mind that CPR training requires frequent practice; without it, you're likely to lose the skills to perform CPR safely.

CPR should be used only if a child meets three criteria: He is unconscious, isn't breathing, and has no pulse. Giving CPR to a child who doesn't meet all of these standards can do more harm than good.

Stay calm. As frightening as this is, you'll need to have your wits about you in order to help. If you haven't called 911 yet, have someone do so immediately while you begin CPR. If no one else is around, first start CPR. Don't worry about doing it exactly right. What matters is that you carry out the steps as quickly as you can.

These five steps, drawn from the guidelines of both the American Academy of Pediatrics and the American Red Cross, are the basics of what to do in a breathing emergency.

Swiftly but gently place your child on his back on a firm surface, unless you think he might have a spinal cord, neck, or back injury. In that case, don't move him.

1. Check your child's consciousness, breathing, and pulse.

•Consciousness: Tickle your child's feet. Avoid shaking him in case his spinal cord is hurt. Shout his name. Pinch his skin.

•Breathing: Make sure his airway is open. Remove any food or other obstruction you see in his mouth. (Remove something from the mouth or entrance to the throat only if you're certain you can do so without pushing it into the throat.) Lift his chin gently with one hand while tipping his head back slowly with the other. Then, for at least five seconds, look, listen, and feel for signs of breathing.

•Pulse: Gently press the index and middle fingers of one hand between the voice box and the muscle that runs down the side of the neck. Feel for a pulse for at least five seconds.

If you determine that your child is unconscious, isn't breathing, and has no pulse, begin child CPR immediately, starting with step 2.

2. Begin rescue breathing. Lift your child's chin to open the airway, and pinch his nostrils shut with your fingers. Position your mouth over your child's mouth, and breathe out for one to one and a half seconds. Watch to see if your child's chest rises. Remove your mouth, and let the chest fall. Repeat, giving your child another breath three seconds later. If his chest does not rise, look again for foreign objects in the throat.

3. Check if his heart is beating. Feel for a pulse by gently pressing two fingers between his voice box and the muscle that runs down the side of the neck, check for a pulse. If you feel a pulse, continue giving one breath every three seconds until your child begins breathing on his own. If you don't feel a pulse, go to the next step.

4. Begin chest compressions. Using two fingers, firmly depress your child's chest one third to one half the depth of their chest. Alternate doing five fast compressions with giving one breath. Check breathing and pulse every minute. Continue until your child has a pulse and begins to breathe on his own.

5. If someone hasn't already done so, call 911 or your local emergency rescue squad or fire department.

As soon as your child expels the object or begins to breathe, call his doctor for further advice.

-- Peter Jaret is a medical writer and book author whose work has appeared in Health, National Geographic, and many other publications. He is the recipient of the 1992 American Medical Association award for medical reporting and the 1998 James Beard Award for journalism.

References

First published August 4, 1999
Last updated July 22, 2008
Copyright © 1999 Consumer Health Interactive

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